RIT Solutions, Inc.
QNXT Configuration Data Analyst Job at RIT Solutions, Inc. in Lutherville Timoni
RIT Solutions, Inc., Lutherville Timonium, MD, US, 21094
Title: QNXT Configuration Data Analyst
Location: Remote (must RESIDE IN CALIFORNIA- NO exceptions)
Duration: 6+ months contract to hire
General Description of Position
The Configuration Data Analyst is responsible for the system configuration, implementation, and conversion of Santa Clara Family Health Plan's (SCFHP) core systems. This position requires accurate interpretation and configuration based on federal and state regulatory guidelines and business contractual agreements that impact benefits, contracts, millions of dollars in claims payments, case management, and grievance and appeals processes.
The analyst will collaborate with internal and external stakeholders to gather requirements, independently analyze and mine data, draw sound conclusions, configure, test, and implement data structures that support SCFHP's managed care information systems. The role ensures alignment with business needs, regulatory compliance, and vendor contractual obligations.
Must have 5 years of experience as a QNXT Configuration Analyst. Must have a minimum QNXT version 5.9
Required Qualifications
Serve as a subject matter expert for the following:
Location: Remote (must RESIDE IN CALIFORNIA- NO exceptions)
Duration: 6+ months contract to hire
General Description of Position
The Configuration Data Analyst is responsible for the system configuration, implementation, and conversion of Santa Clara Family Health Plan's (SCFHP) core systems. This position requires accurate interpretation and configuration based on federal and state regulatory guidelines and business contractual agreements that impact benefits, contracts, millions of dollars in claims payments, case management, and grievance and appeals processes.
The analyst will collaborate with internal and external stakeholders to gather requirements, independently analyze and mine data, draw sound conclusions, configure, test, and implement data structures that support SCFHP's managed care information systems. The role ensures alignment with business needs, regulatory compliance, and vendor contractual obligations.
Must have 5 years of experience as a QNXT Configuration Analyst. Must have a minimum QNXT version 5.9
Required Qualifications
Serve as a subject matter expert for the following:
- QNXT
- NetworX
- Optum CES (Claims Editing System)
- Medi-Cal experience
- Troubleshoot a wide range of business and system production issues by:
- Reviewing reported problems
- Conducting research using internal/external documentation (e.g., regulatory publications, user guides)
- Performing detailed analysis and critical thinking
- Testing to identify root causes
- Documenting findings and recommending solutions
- Perform system configuration and maintenance tasks of varying complexity, including:
- Benefits
- Authorizations
- Contracts
- Fee schedules
- DFRs
- Capitation
- Letter templates
This work supports both production issue resolution and new business/regulatory requirements.
- Create and maintain SQL scripts to support business and system processes.
- Provide training and cross-training on system features and new releases to business units.